1 / 31

Chapter 22

Chapter 22. Antiinflammatory, Musculoskeletal, and Antiarthritis Medications. Chapter 22 Lesson 22.1. Learning Objectives. List medications commonly used for the treatment of minor musculoskeletal pain and inflammation

cpatterson
Download Presentation

Chapter 22

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 22 Antiinflammatory, Musculoskeletal, and Antiarthritis Medications

  2. Chapter 22 Lesson 22.1

  3. Learning Objectives • List medications commonly used for the treatment of minor musculoskeletal pain and inflammation • Compare the actions of various antiinflammatory and muscle relaxant agents • Identify the appropriate use for musculoskeletal relaxants

  4. Muscular and Skeletal Systems • Bones, joints, muscles, and ligaments • Antiinflammatory and analgesic drugs • Skeletal muscle relaxants • Drugs used to treat arthritis • Drugs used to treat gout

  5. The Skeletal System

  6. The Muscular System

  7. The Muscular System

  8. The Inflammatory Response • Triggers to inflammation • Phases of the inflammatory response • Symptoms of inflammation • Cellular response

  9. Antiinflammatory and Analgesic Agents • Aspirin: acetylsalicylic acid (ASA) • Acetaminophen • NSAIDs

  10. Salicylates Action • Analgesic, antipyretic, and antiinflammatory effects • Stop the production of prostaglandins • Table 22-1 Uses • Treatment of mild to moderate pain; reduces the risk of myocardial infarctions and stroke, as well as transient ischemic attacks (TIAs) in men • First-line therapy for various forms of arthritis, fever, myalgia, neuralgia, arthralgia, headache, and dysmenorrhea • Systemic lupus erythematosus, acute rheumatic fever

  11. Salicylates (cont.) Adverse Reactions • Tinnitus, visual disturbances, edema, urticaria, anorexia, epigastric discomfort, and nausea Drug Interactions • Alcohol use increases the chance for GI bleeding; NSAIDs; sulfonamides, sulfonylureas; phenytoin

  12. Salicylates (cont.) Nursing Implications • Assessment, diagnosis, planning, implementation, and evaluation Patient Teaching • Administration time, adverse effects; time for drug effectiveness; implications for drug interactions and when to contact the healthcare provider; storage and safety; other routes of administration if PO is not tolerated

  13. Acetaminophen • Over-the-counter drug used to treat fever and pain; no antiinflammatory effect • Action: antipyretic – direct action of the hypothalamic heat-regulating center; blocks pyogenic cytokines through vasodilation and sweating • Use: chronic, nonmalignant pain; osteoarthritis • Adverse reactions: rare blood response; liver toxicity; overdosage can be fatal • Drug interactions and hepatotoxicity

  14. Nonsteroidal Antiinflammatory Drugs • Action: unknown; may block prostaglandins; analgesic, antiinflammatory, and antipyretic effects • Uses: rheumatic disease, degenerative joint disease, osteoarthritis, and acute musculoskeletal problems • Adverse reactions: GI most common • Drug interactions • Nursing implications and patient teaching

  15. Skeletal Muscle Relaxants • Action: reduce muscle tone and involuntary movement without loss of voluntary motor function • Centrally acting or direct myotropic blocking • Uses: relief of pain in musculoskeletal and neurologic disorders involving peripheral injury and inflammation; relief of spasticity in chronic conditions • Table 22-2

  16. Skeletal Muscle Relaxants (cont.) • Adverse reactions: symptoms • Drug interactions: sedatives, narcotic analgesics, antianxiety agents, hypnotics, alcohol, general anesthetics, MAOIs, and tricyclics • Cyclobenzaprine and orphenadrine: anticholinergic effects that interfere with antihypertensive activity of alpha-adrenergic blockers

  17. Skeletal Muscle Relaxants (cont.) • Nursing implications: assessment, diagnosis, planning, implementation, and evaluation • Patient and family teaching: administration considerations; avoiding activities requiring alertness; drug interactions; missed dosages; when to contact the health care provider; HS administration; storage and safety

  18. Chapter 22 Lesson 22.2

  19. Learning Objectives • Explain the mechanisms of action for different antiarthritis medications • Describe adverse reactions often found in the use of antiarthritis medications • Describe the clinical situations in which uricosuric therapy may be indicated

  20. Antiarthritis Medications • Inflammation of the joints • Rheumatoid arthritis: autoimmune response • Osteoarthritis: local joint destruction of weight-bearing joints • Symptoms • Complementary and Alternative Therapies

  21. Slow-Acting Antirheumatic Drugs SAARDs • Gold Compounds • Hydroxychloroquine sulfate • Penicillamine • Methotrexate

  22. Gold Compounds • Chrysotherapy • Action: unknown; interference with biochemical reactions at the cellular level; inhibit lysosomal enzyme activity; effect on antigen response in rheumatoid arthritis; stops synovitis • Adverse reactions and toxicities • Dosage and administration • Forms of medication

  23. Hydroxychloroquine Sulfate • Action: unknown; antimalarial drug; acts to stop antigen formation in the body • Uses • Adverse reactions • Drug effectiveness • Drug interactions

  24. Infliximab • Action/Use: in combination with methotrexate to reduce signs and symptoms of rheumatoid arthritis, Crohn’s disease, other orthopedic inflammatory or destructive processes • Adverse reactions: FDA warning; symptoms

  25. Leflunomide • Action: pyrimidine synthesis inhibitor that has an antiinflammatory effect • Use: adults with rheumatoid arthritis • Therapy: initial and maintenance • Adverse reactions: FDA warning label

  26. Methotrexate • Action: unknown, may affect the immune function to reduce inflammation • Uses: treatment of cancer and rheumatoid arthritis • Toxicities

  27. Penicillamine • Action: chelating agent • Use: rheumatoid arthritis • Nursing implications: assessment, diagnosis, planning, implementation, evaluation • Patient and family teaching: treatment length/drug effectiveness; toxic effects; when to contact healthcare provider; monitoring; brief pain increase following injection; adverse reactions

  28. Antigout Medications • Uric acid • Uric acid levels; crystal formation • Symptoms • Gouty arthritis • Relief of pain and inflammation – acute period • Uricosuric agents • Table 22-4

  29. Uricosuric Agents • Action: increase excretion of urate salts in the urine by blocking tubular reabsorption of these salts in the kidney; decrease amounts of circulating urate and deposition of urate; promote reabsorption of urate deposits • Uses: reduce uric acid levels in patients who do not excrete enough uric acid

  30. Uricosuric Agents (cont.) • Adverse reactions: drug-specific symptoms • Drug interactions • Salicylates • Increased drug effects • Acidifying and alkalinizing agents • Anticoagulants • Hypersensitivity reactions

  31. Uricosuric Agents (cont.) • Nursing implications: assessment, diagnosis, planning, implementation, evaluation • Patient and family teaching: preventing attacks; drug administration; diet and fluid intake; self-monitoring of urine and stools; when to contact the health care provider; colchicine administration; drug interactions

More Related